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  • Clopidogrel plus aspirin did not differ from aspirin alone for reducing MI, stroke, and CV death in high risk atherothrombosis

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Therapeutics
Clopidogrel plus aspirin did not differ from aspirin alone for reducing MI, stroke, and CV death in high risk atherothrombosis

https://doi.org/10.1136/ebm.11.5.143

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    Bhatt DL, Fox KA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006;354:1706–17.
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 Q In patients with high risk atherothrombosis, is long term treatment with clopidogrel plus aspirin more effective than aspirin alone for reducing cardiovascular (CV) events?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Neurology ★★★★★★☆ Cardiology ★★★★★★☆

    METHODS

    Embedded ImageDesign:

    randomised placebo controlled trial (Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilisation, Management, and Avoidance [CHARISMA]).

    Embedded ImageAllocation:

    concealed.*

    Embedded ImageBlinding:

    blinded {clinicians, patients, data collectors, outcome assessors, data analysts, and data safety and monitoring committee}†.*

    Embedded ImageFollow up period:

    median 28 months.

    Embedded ImageSetting:

    768 sites in 32 countries.

    Embedded ImagePatients:

    15 603 patients ⩾45 years of age (median age 64 y, 70% men, 80% white) who had multiple atherothrombotic risk factors (type 1 or 2 diabetes, diabetic nephropathy, ankle brachial index <0.9, asymptomatic carotid stenosis ⩾70% of luminal diameter, ⩾1 carotid plaque, systolic blood pressure ⩾150 …

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    Footnotes

    • ↵* See glossary.

    • ↵† Information provided by author.

    • For correspondence: Dr E J Topol, Case Western Reserve University, Cleveland, Ohio, USA. eric.topol{at}case.edu

    • Sources of funding: Sanofi-Aventis; Bristol-Myers Squibb; National Institutes of Health.

    Linked Articles

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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2006; 11 159a-159a Published Online First: 29 Sep 2006. doi: 10.1136/ebm.11.5.159a